J9306 HCPCS code: Injection, pertuzumab, 1 mg
J9306 is the HCPCS Level II code for injection, pertuzumab, 1 mg. In 2024 Medicare paid an average of $12.14 per service for J9306 across 6,371,992 services. Its Medicare coverage code is C (Carrier judgment): Coverage is decided by the Medicare contractor (MAC) case by case. The NCCI unit limit is 840 per day on outpatient hospital claims. Medicare volume fell 30% from 2022 to 2024 (9,040,157 to 6,371,992 services). In 2024, about 2,154 clinicians billed Medicare for J9306 for 2,011 beneficiaries; California, Florida, Texas accounted for 38% of services.
Code details
| Field | Value |
|---|---|
| Section | J codes — Drugs administered other than oral method |
| Coverage code | C — Carrier judgment |
| Pricing indicator | 51 — Drug or biological (priced per ASP/average sales price rules) |
| BETOS category | O1D — Chemotherapy |
| Added | 2014-01-01 |
| Last action effective | 2014-01-01 |
Who bills J9306 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 2,154 |
| Medicare beneficiaries | 2,011 |
| States with claims | 35 |
| Share of services in top 3 states (California, Florida, Texas) | 38% |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for J9306, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 9,040,157 | 2,779 | $13.54 | $10.81 |
| 2023 | 7,670,311 | 2,367 | $14.38 | $11.45 |
| 2024 | 6,371,992 | 2,011 | $15.24 | $12.14 |
States with the most J9306 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| California | 983,595 | $12.17 |
| Florida | 803,986 | $12.07 |
| Texas | 558,180 | $12.17 |
| New York | 304,503 | $12.28 |
| Arizona | 245,700 | $12.32 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 840 | Prescribing Information |
| practitioner claims | 840 | Prescribing Information |
What changed for J9306
- 2014-01-01: J9306 added to HCPCS Level II
- Next scheduled CMS quarterly update (HCPCS and DMEPOS fee schedule): 2027-01-01
Frequently asked questions
What is HCPCS code J9306?
J9306 is the HCPCS Level II code for injection, pertuzumab, 1 mg. Short descriptor: "Injection, pertuzumab, 1 mg".
How much does Medicare pay for J9306?
In 2024, the average Medicare payment was $12.14 per service (average allowed $15.24).
Does Medicare cover J9306?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
How many units of J9306 can be billed per day?
840 on outpatient hospital claims; 840 on practitioner claims (NCCI medically unlikely edits).
Related J93 codes
- J9300 — Injection, gemtuzumab ozogamicin, 5 mg
- J9301 — Injection, obinutuzumab, 10 mg
- J9302 — Injection, ofatumumab, 10 mg
- J9303 — Injection, panitumumab, 10 mg
- J9304 — Injection, pemetrexed (pemfexy), 10 mg
- J9305 — Injection, pemetrexed, not otherwise specified, 10 mg
- J9307 — Injection, pralatrexate, 1 mg
- J9308 — Injection, ramucirumab, 5 mg
- J9309 — Injection, polatuzumab vedotin-piiq, 1 mg
- J9310 — Injection, rituximab, 100 mg
- J9311 — Injection, rituximab 10 mg and hyaluronidase
- J9312 — Injection, rituximab, 10 mg
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Next steps
- Run a reimbursement report for a device billed under J9306
- Watch J9306 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J9306
Sources: CMS HCPCS Level II release October 2025; CMS DMEPOS fee schedule; CMS NCCI MUE tables; CMS Medicare utilization (physician and DME supplier files); CMS Medicare Coverage Database articles. Fees are Medicare allowables, not commercial rates. Not billing or legal advice.